Local physicians say Dr. Charles Ross' departing Paducah to join the faculty of Vanderbilt University Medical Center will create a much bigger void in surgical specialists who are getting harder to find.

The reasons: soaring malpractice insurance, dwindling population, competition with bigger-city hospitals and fewer doctors being produced.

"I think his leaving will be significant," said Dr. William Wheeler, a retired vascular surgeon like Ross and former chief executive officer at Lourdes hospital. "I think we have great doctors here who will continue to do what they've been doing, but they pretty much all have full practices, and they won't be able to absorb all the patients that Dr. Ross is handling."

Remaining vascular surgeons in Paducah are Ross' partner, Dr. Tim Ranval, as well as physicians Mike Jones and Joe Mayo.

Ross, medical director of the Lourdes Vascular Center, will begin seeing patients in July as director of endovascular surgery at Vanderbilt. He has been a clinical faculty member there since the mid-1990s.

Ross is a regionally recognized expert in various endovascular techniques and will leave a substantial practice at both Lourdes Medical Center and Western Baptist Hospital.

"I can't say enough great things about the experience I've had in Paducah," Ross said. "I've had the most wonderful patients that any doctor could hope to have. I'm going to Nashville with mixed emotions because I love my patients and my staff."

Ross agreed with Wheeler and Dr. Harry Carloss of Paducah that it is becoming increasingly difficult to recruit surgical specialists because Kentucky is deemed a high-risk state for malpractice insurance. But Ross said he hasn't been sued and is leaving solely because he got an offer he couldn't refuse.

"I'm leaving because I've always had an academic approach to surgery, and now I have a chance to go to one of the premier teaching hospitals," Ross said.

"Otherwise I would stay here and fight it out," he said of the malpractice situation. "When you talk to young surgeons, many times they're frightened by coming into this environment."

Carloss, a past president of the Kentucky Medical Association, said Kentucky has higher malpractice premiums than surrounding states, but legislation to fix the problem died earlier this year.

"I think 98 percent of the people trained in surgical specialties at the University of Louisville and University of Kentucky left the state last year, so it's a very difficult situation," Carloss said. "We have a problem here not only with vascular surgery, but with neurosurgery and orthopedic surgery. People frequently have to be taken out of town for these types of surgeries."

The medical community was booming when Wheeler arrived 15 years ago, but Paducah since has lost three vascular surgeons, four or five orthopedic surgeons and three neurosurgeons, Wheeler said. "Kentucky is one of the highest-risk states for malpractice insurance and we haven't addressed that issue."

Another problem, as doctors retire and move away, is the area population isn't growing, he said. "Our base of patients is not increasing and our percentage of Medicare-Medicaid, which doesn't quite pay the expenses, is certainly growing out of proportion to insurance patients."

Wheeler said the nationwide demand for specialists far exceeds those being trained, "so you have to have some kind of drawing card if you're going to a place like Paducah."
He said he has spoken with Mayor Bill Paxton and Greater Paducah Economic Development Council Chairman David Denton about the need for economic incentives to recruit doctors, who are a big part of local commerce.

Community hospitals here and regionally are finding it harder and harder to keep up with advancing technology as compared with larger hospitals, Carloss said. "There may corne a time when community hospitals such as these two can't afford sophisticated equipment and referrals."

Ross said the vascular care system at Lourdes has been excellent.

"I wish I could take my whole team from Lourdes to Nashville with me. It's just been a great honor because of what those people have allowed me to do," he said. "We've brought in every state-of-the-art vascular advancement because we've had such a strong team."

Ross started using carotid artery stenting in high-risk surgical patients in 1996 and repairing abdominal aortic aneurysms in 1999. He now is principal investigator for programs at Lourdes and Western Baptist for carotid artery stent trials in high-risk surgical patients.

Ross also praised Wheeler and other local surgical specialists for their care and expertise. "What a great privilege and honor it has been to work with them," he said.
He has deep western Kentucky roots, with two grandmothers - Jessie Powell and Lunnelle Ross - still living in Marshall County. Ross said he also is related to Goins families in Lyon and Livingston counties.